Acupuncture For Running Injuries

July 11, 2015

I was the kid who couldn’t run a mile in gym class. Remember the fitness awards in elementary school? You had to reach a certain goal in tests like the v-sit, pull ups, sit ups, and of course, the dreaded mile. My 13 minute mile time always held me back from getting an award, so from elementary school until my early 30’s, I pretty much despised running. However just a few years ago, my boyfriend started to drag me out for mile runs. It was torture, but my endurance gradually improved. I’m still a novice, but now run about 12 miles a week and absolutely LOVE it! Nothing gives me more energy, and it’s a great way to spend more time outside.

Although I am relatively new to running, I have been working with runners my entire acupuncture career. I now get why runners are absolutely hell-bent on returning from an injury quickly- it’s a totally addictive sport! Acupuncture is fantastic for treating a multitude of running injuries, ranging from plantar fasciitis to runner’s knee to IT Band pain and tightness.

These are the most common issues I treat for runners:

Plantar Fasciitis- Plantar fasciitis is an inflammation of the tendons of the arch of your foot. The most common symptoms are heel pain when running or walking, but it is especially painful first thing in the morning. This is one of those conditions that responds quite magically to acupuncture! By needling the attachment site of the plantar fascia, pain is greatly reduced and your body’s own healing process is initiated. I also instruct my patients on stretches and exercises to prevent recurrence of the pain.

IT Band Syndrome- Symptoms can include pain and tightness on the outer thigh, hip or outer knee. Acupuncture points along the IT band can help to break up scar tissue and speed healing, getting you back on the track sooner.

Piriformis Syndrome/Sciatica- This results in a sharp or shooting pain that starts in one glute and travels down the leg. However, it doesn’t always go all the way down the leg, and sometimes the pain is more concentrated in the glute and lower back. The piriformis is a muscle in the center of your glute which is very close to your sciatic nerve (the longest nerve in the body, which starts in the pelvis and travels down to your outer foot). When the piriformis muscle is too tight or otherwise inflamed, it creates pressure on the sciatic nerve, resulting in this sharp pain. I needle into the piriformis itself, which releases and relaxes it. Many times someone can feel a little “jump” in the muscle when this happens. It’s very effective, and by needling points along the associated acupuncture meridians and other muscles in the low back and hips, I can often get this type of pain under control within just a few sessions.

Tight, sore or strained muscles- Runners can get especially tight back, neck, hamstring and calf muscles. Acupuncturists can needle special areas of the muscle called trigger points or motor points to relax and lengthen the muscle back to its normal, healthy state.

Patello-femoral pain syndrome (PFPS), also called Runner’s knee– Runner’s knee is extremely common. The usual symptoms include either sharp, sudden pain on the top or sides of the kneecap or dull and achy pain in the same area. It normally doesn’t bother you during a run, but immediately afterwards. It’s caused by weak quadriceps and overly tight hamstrings, which leads to inefficient and misaligned tracking of the patella (kneecap). Women tend to get PFPS more often than men, which researchers believe is due to wider hips leading to increased internal hip rotation and hip adduction. I needle specialized points around the kneecap and along the associated acupuncture meridians to reduce pain and balance the muscles.

Patellar Tendonitis- This is a knee injury that tends to afflict men more often. Symptoms include pain just below the patella (kneecap) that is worse with kneeling or movement of the knee in general. There are a few rehabilitative exercises which are especially helpful, including strengthening the anterior tibialis muscle (along the front lower leg) and eccentric squats (going downward only) while standing on a board which is tilted in a decline- your toes end up lower than your heels. For more details on this exercise see this study.

Achilles’ Tendonitis- Symptoms include pain and tightness anywhere along the Achilles’ Tendon (between your lower calf and heel, on the back of your leg). This is another issue for which I have found acupuncture is very effective.

Shin Splints- symptoms include pain along the fronts of the mid- lower legs when running. It most commonly happens to new runners or those who are increasing mileage quite quickly. Without proper rest and healing, it can become a chronic issue. Be careful to differentiate this from a stress fracture, in which the pain is usually more pinpointed, whereas with shin splints it is more diffuse. Acupuncture points along the middle of the “shin bone” (tibia) can decrease pain and accelerate healing quite effectively.

Tips for avoiding injury:

– 10% Rule: Don’t increase your mileage on any given week by more than 10% of the previous week. When you’re really looking to increase mileage, this can seem like painfully slow going. But the benefits and injury prevention is totally worth it in the end!

– Rest days: This is not only important for improving your performance, but giving your muscles and joints a few days per week (not necessarily consecutive days) to rest will help any inflammation to subside and give your muscles chance to fully heal, making them stronger and better conditioned.

– Cross Training- plyometrics, light weight training and core strengthening are three things every runner should be doing on a regular basis. All three are crucial to strengthen and balance your muscles and aid in injury prevention. Just one example: Runner’s knee (see above) can be treated and prevented through strengthening your quadriceps muscles. This helps your body stabilize the kneecap, resulting in less friction against the cartilage, and therefore less knee pain.

– Time for stretching and warm up/cool down- this seems like a no-brainer, but what exactly is the benefit? As far as the warm up part, it gradually sends more blood flow to your muscles, which can definitely prevent injury. The cool down portion allows your heart rate and blood pressure to slowly return to normal.

As for stretching, research is inconclusive- it may not actually make you more flexible! If the only time you ever stretch is after a workout, it probably isn’t doing much to increase your range of motion (although it certainly feels good!). Where you can gain more flexibility is in your day to day life: using a standing desk instead of sitting, and stretching frequently throughout the day. Furthermore, I completely agree with the article above (linked)- being more flexible is not necessarily a good thing! When I used to be a hard-core yoga enthusiast and was extremely flexible, I had a ton more back problems than I do now that I primarily run and am much less flexible. Of course it may not be the only reason my back is better now, but it just goes to show you. Flexible people get injured, too!

–Proper footwear. There is a lot of debate in the running community about whether minimalist shoes or shoes with more padding are best for injury prevention and proper form. Whichever you choose, be sure to get your shoes from a running specialty store. Employees here are usually quite knowledgeable about which fit will be best for your needs, and can even do a gait analysis on an in-store treadmill. If you are a beginner, this is especially important. Experts agree that shoes should be replaced after roughly 300-500 miles, if the tread is significantly worn down or if the sole of the shoe at the heel looks crushed.

Keep in mind that in most cases acupuncture effectively treats the symptoms and helps your body to heal, but you also need to address the cause of your injury in order to prevent it from recurring. This can involve cross training, an analysis of your running mechanics or rehabilitative exercises. If it seems like you are constantly dealing with injuries, I recommend consulting with an experienced sports medicine doctor or running coach.

For even more information on acupuncture for athletes, check out this blog post!